Caloren

Indications

Calcitriol is the active form of vitamin D. It is used for low calcium and bone disease in people with chronic kidney disease (including those on dialysis), for underactive parathyroid glands (hypoparathyroidism), for some types of rickets that do not respond to ordinary vitamin D, and in some cases for osteoporosis after menopause.

How It Works

Healthy kidneys turn ordinary vitamin D into calcitriol. Taking calcitriol directly helps the gut absorb calcium and phosphate and supports healthy bones, even when the kidneys cannot make it.

Dosage and Administration

The dose is set for each person according to blood calcium levels. Adults usually start with 0.25 mcg a day, and the doctor adjusts it slowly. For osteoporosis, a common dose is 0.25 mcg twice a day. Injections are given by a doctor or nurse, usually during dialysis, as prescribed. Take capsules at the same time each day. Regular blood tests for calcium are needed.

Interactions

• Do not take other vitamin D products (such as Cholecalciferol or Alfacalcidol) at the same time unless the doctor says so.
• Thiazide diuretics (such as Hydrochlorothiazide) and calcium supplements can raise calcium too much.
• High calcium increases the risk of heart rhythm problems with Digoxin.
• Magnesium-containing antacids can cause high magnesium in people on dialysis.
• Cholestyramine reduces absorption; Corticosteroids, Phenytoin and Phenobarbital can reduce its effect.

Contraindications

High blood calcium, signs of vitamin D poisoning, or allergy to calcitriol or any ingredient of the product.

Side Effects

At the right dose, side effects are uncommon. Most problems come from calcium rising too high: tiredness, weakness, headache, nausea, vomiting, constipation, dry mouth, thirst, a metallic taste, and muscle or bone pain.

Get urgent medical help for:

• Confusion, severe drowsiness or severe vomiting.
• An irregular or very fast heartbeat.
• Extreme thirst with passing large amounts of urine.
• Severe pain in the side or back (possible kidney stone).
• Swelling of the face or throat, or a severe rash.

Pregnancy and Lactation

Use in pregnancy only if the doctor decides it is needed, with close calcium checks. It passes into breast milk; if it is used while breastfeeding, the doctor may check the baby's calcium.

Precautions and Warnings

• Keep all blood test appointments for calcium, phosphate and kidney function.
• Follow the doctor's advice on calcium in the diet and on calcium or phosphate binder tablets.
• Drink enough fluids, and tell the doctor about kidney stones or heart problems.
• People who cannot move for long periods (for example after surgery) are more likely to develop high calcium.

Overdose

Too much can cause dangerously high calcium, with vomiting, confusion, weakness and heart rhythm problems. Get emergency medical help.

Therapeutic Class

Vitamin D analogue (active vitamin D).

Storage

Store below 30°C in a dry place, away from light and out of the reach of children.